Pharmacology - part 1 Flashcards
First line treatment for to prevent coronary vasospasm in a subarhnoid hemorrhage
Nimodiopine 60mg every 4 hours
can crush and put in their NG tube if needed
First line treatment for idiopathic intracranial hypertension
Acetozolimide
Pts older than 50 or alcholics needing treatment for meningitits get what ?
Ceftriaxone, Vancomycin, Ampilicillin
medications is considered first line therapy for absence seizure
Ethoxsimide
what is the treatment of a UTI in a pregnant patient
cephalexin 500 mg QID for 7 days
what is the treatment for prostitiis in an elderly male >60
Ciprofloxacin for 30 days
what is the treatment for hyperkalemia
- Calcium - stabilize cell
- Sodium bicarb - shift into the cell
- Furosimide - Eliminate from the body
What is the treatment medication for prostate cancer
leuprolide
Treatment for pheochromocytoma
phentolomine & Lobatol
Contrindication for Gemfibroazol (hypertriglyceridemia)
Biliary disease
First line treatment for HHS
Fluids
then insulin
First line treatment for Diabetes insipidis
Desmopressin
what drug causes ginvival hyperplasia
Pheytonin
Treatment for pregnant women with non-bloody diarrhea
Azithromycin
Treatment for allergic conjuncitivits
Olopatidine drops
Best effective treatment agasint dental caries
Flouride
Normal dose of Vit D for infant
400 IU
First line treatment for acute sinutits
Oxymetazoline and pseduoephrine
Ranolazine
what drug class ?
Anti-anginal medication
for stable angia
next step after bblocker, nitro, statin
What medication is contrindicated in wolff parkinson white syndrome?
ABCD adensoine beta-blockers calcium channel blockers digoxin
what do inotroph drugs do
increases or decreases heart muscle contraction
Ibutilitde what drug class and what does it do
for A fib with wolff parkinson white together
antiarythmic
what drug can be used in pregnant patient for manic episode
Haldoperidol
mom just delvered baby and mom is having a seizure what medication do you give her
magnesium sulfate
Treatment for BPH
Finestride
biochemical physical effect of drugs on the body or on microorganisms or parasites within or on the body
Pharmacodynamics - what the drug does
Absorption, distubtion and metbolism and elinimation of a drug
Pharmacokinetics
What is a type A adverse drug reaction
dose related
what is the type B adverse drug reaction
dose independent
allergic response - rash but not anaphylsis that is type A
immune mediated
what are the types of Pharmacokinetics
“ADME”
absorption- increased or decreased transit time
Distribupation - binds to plasma protiens
Metabolism - increase or decreased - age, CYP 450
Exrection - increase or decreased renal funciton
what does CYP 450 do
it is a protein in the liver that helps break down drugs
what are the types of pharmacodynamic adverse drug reactions
exaggerated - like benzo, alcohol
competitive- beta-blocker, albuterol
Where do you report adverse drug reactions
medwatch - FDA website
call manufacture
consult pharmacist
inform the patient
What are all the types of hypersensitivity reactions ?
"ACID" type 1 anaphylaxis type 2 cytotoxic - HIT type 3 immune complex - serum sickness, anti-venom type 4 poison ivy, PPD
what pregenacy catgegory is Thalidomide (leprosy preventor or help in treatment of MM)
X- severely teratogenic
What pregnancy Category:
Studies fail to demonstrate a risk to fetus in 1 st trimester
Category- Type A
What pregnancy Category:
Animal studies fail to show risk, and no studies in humans
Category- Type B
What pregnancy Category:
Animal studies show risk, but no human, studies performed
Category- Type C
What pregnancy Category:
Positive evidence of fetal risk in humans but benefits greater in some situations
Category- Type D
What pregnancy Category:
Studies show abnormalities, risk always outweighs benefits
Category- Type X
All pregnancy cateogories - simple version
type A- safe type B- fail to show risk in animals type C- show risk in animals type D - evidence of fetal risk to humans type x - risk out weights benefit
MOA: inhibits CNS protaglandins & head regulating centers in hypothalamus
Acetaminophen- tylenol
no antiinflammatory effects ***
Drug class:
Tylenol
Vicodin
Percocet
Acetaminophen
Adverse Drug reaction:
Acetaminophen
Nephropathy - diseased kidneys
hepatoxicity
Drug class:
Naproxen
Ketorolac
Meloxicam
NSAIDs - nonstredoial anti-inflammatory
MOA: inhibits prostaglinids by reversibly blocking COX
NSAIDS
Adverse Drug reaction:
NSAIDS
GI upset Peptic ulcer disease Prolonged bleeding time nephropathy allergic reactions bronchospasms- dont use if plumonary disease present
Drug class:
aspirin
Salicylates
MOA: inhibits prostaglinis synthesis by irreversibly blocking COX
Aspirin - Salicylates
Avoid NSAIDS in which patients ?
plumonary dysfunction - can cause bronchospasms
COPD
Asthma
name good times to use Salicylates
Antipyretic
acute conoar syndrome
cerebroprotective
kawasaki
Adverse Drug reaction: to Aspirin
Can cause GI upset peptic ulcer disease prolonged bleeding time nephropathy allergic reaction reye syndrome *** dont use in children
avoid aspirin in what patients
plumonary dysfunction - can cause bronchospasms
COPD
Asthma
*same as NSAIDS
Drug class:
Morphine
codeine
methadone
Opioids
When do you use opioids?
analgesia
antitussive- codeine
anesthesia-adjunct
Adverse Drug reaction: Opioids
SPEND
SCRAM
S- sedation P- postural hypotension E- euphoria N- nausea D - derm rashes
S- Sex hormone drugs C- constipation ***R- respiratory depression***** A- addiction M- miosis - pinpoint pupils
what is the reversal agent to opoids
Naloxone - Bupromorphine
What are DMARDS
PAIN MEDICATIONS - rhematoid arthritis Methotrexate Leflunomide Sulfasalazine Hydroxychloroquine Minocycline - NOT FDA approved
MOA: inhibitis dihydrofolate reductase
Methotrexate - DEMARD
DMARDS are good drugs for what disease
Rheumatoid Arthritis
Methotrexate
Adverse drug reactions: DMARDS
remember decreases folate- GI - N/V/D Hematologic Teratogenic - methotreXate hepatic
What drug class: Etanercept infliximab adalimumab golimumab certolizumab
Biologic DMARD
TNF inhibtor
What drug class:
abatacept
Biologic DMARD
T cell inhibitor
What drug class Rituximab
Biologic DMARD
-B cell modifier
what drug class Tocilizumab
Biologic DMARD
- IL-6 inhibitor
what drug class anakinra
Biologic DMARD
- IL-1 inhibitor
MOA: Target pro-inflammatory mediators
Biologic DMARDS
Adverse drug reaction to biologic to DMARD
They are injectables so site reactions
GI
Black box warning* infections, tuberculosis
Drug class-
Metformin
Biguanide
MOA: decreases hepatic glucose output, inhibits gluconeogenesis converts intestinal glucose to lactic acid
Biguanide - Metformin
When to use metformin?
Type 2 DM
PCOS
adverse drug reaction:
Metformin
Hypoglycermia DOES NOT OCCUR
if too high can cuase lactic acidosis
check renal functions
Drug class:
Glyburide
Glipizide
Glimepiride
Sulfonylureas
MOA: stimulates B-cells to release insulin, increasing insulin sensitivity
Sulfonylureas - Glyburide, Glipizide
when to use Sulfonylureas
Type 2 DM
Adverse drug reactions to Sulfonylureas
Hypoglycemia
weight gain
disulfiram like reaciton *
Avoid if severe renal failure ***
Drug class:
Rosiglitazone
Pioglitazone
Thiazolidinediones
MOA: decrese hepatic glucose production by increasing liver and muscle sensitivity to insulin
Thiazolidinediones - Rosiglitazone, Pioglitazone
Adverse Drug reactions: Thiazolidinediones
Hepatotoxicity
Cardiovascular- MI, CHF
BLACKBOX IN ANY HEART PROBLEMS
Drug class: Sitagliptin Saxagliptin linagliptin allogliptin
Dipeptidyl peptidase- 4
DDP-4
MOA: Increase the action of endogenous incretin
THEY ARE ADD ON MEDICATIONS
think of decreasing the appetite drug
Dipeptidyl peptidase- 4 —- DDP-4
Sitagliptin, saxagliptin, linagliptin
Adverse drug reactions to Dipeptidyl peptidase- 4 —- DDP-4
Nasopharyngitis
Pancreatitis
Drug class:
Dapaglifozin
Empagliflozin
Canaglifozin
Sodium glucose co-transporter 2 —– SGLT 2
think “FLOZIN” will cause glucose in urine
MOA: blocks glucose by the re-absorption by the kidney
Sodium glucose co-transporter 2 —– SGLT 2
Adverse drug reactions
Dehydration
UTI
Vaginal yeast infection
infections
Which drug:
Black box warning for lactic acidosis
Metformin- Biguanide
Which drug:
Treatment for Type 2 DM and can cause Hypoglycemia
Sulfonylureas
Which drug: Treatment for Type 2 DM and have to avoid if severe renal failure
metformin and Sulfonylureas (glyburide, glipidze)
Which drug: Treatment for type 2 DM, black box warning for Cardiovascular disease
Thiazolinidiones
rosiflitazone
pioglitazone
Which drug: Treatment for type 2 DM, can cause nasopharyngitis & pancreatitis
Dipeptidyl peptidase- 4
DDP-4
sitagliptin, saxagliptin
Which drug: Treatment for type 2 DM, can cause dehydration, UTI, vaginal yeast infections
Sodium glucose co-transporter 2 —– SGLT 2
dapagliflozin, empagliflozin
Drug class: Exenatide Liraglutide ablitutide dulatiglutide
Glucagon like peptide- 1 —– GLP-1
INJECTABLE
MOA: Acts on pancrease to modulate & enhance insulin secreation in response to meals
Glucagon like peptide- 1 ----- GLP-1 Exenatide Liraglutide ablitutide dulatiglutide
MOA: exogenous protein that mimics endogenous insulin
Insulin
Adverse drug reactions: Insulin
Hypoglycemia – if taking too much
Lipodystrophy
Weight gain
allergic reaction
Treatment for Hyperkalemia and DKA
Insulin
